478 LOT NO.
+Pjp. STI H
APPLICAp�'� FOR APPLIANCE PERMIT
�f5G1 �CUPERTINO
AP
Dater, Permit No.6
Fee S /"36
Applejgrl isfiC�ebfl}I�tRTJjj& of Cupertino for a permit to install
gas upplia �y�1�� liys raj on��{f�`i++e''re''vverse side hereof, and agrees to install said
appliances in accordance with the provisions of the Plumbing [:ode of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises Q'64'C'eLe rt<,4
u Ownet�C ' /� c^ CT`^� �L�_ Address _
Ry DIVISION Address a _.
G &dMi�11MCTAtEft
hone SUNNYOAKS AVE., CAMPBELL. CALIF: Approve
PLUNHING INSPECT
0 cm m
TJ
-------- ---- - - -- - - - -
A,��' GAS SERYICE .NOTICE OFFICE
COPY
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTTIINNQ
f/ " � _................ 19h1
You are hereby auth ' ed to connect the
�GAS service for
Owner or Tenant ... ..... OSYF
..............................................
e—
// New Service ....................
No. of Meters .....L................ Reconnect ..............................
Move Service ........................
No. of Add. Meters .............. Move.Meter ..........................
...................... ................
ING INSPECTOR
Ito t/6o-5oo '